Frequent ejaculation associated free radical and lactic acid accumulation cause noninfectious inflammation and muscle dysfunction: a potential mechanism for symptoms in Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

BACKGROUND

The prevalence of prostatitis is extremely high, with vast majority belongs to National Institutes of Health Category III: Chronic Prostatitis (CP)/Chronic Pelvic Pain Syndromes (CPPS). The etiology of CP/CPPS is noninfectious, with no precise mechanisms has been elucidated to date.

HYPOTHESIS: During male ejaculation, the pelvic muscles undergo coordinated intense contraction to expel the semen out of the male genital tract, a process associated with locally increased levels of lactic acid and free radicals as byproducts. In this regards, repetitive sexual activities with frequent ejaculation would impede the drainage and cause accumulation of these byproducts in the pelvic region, triggering consequent local pathophysiological changes such as edema, venous dilation and muscular malfunction, which further leads to common complaints in CP/CPPS patients such as lower urinary tract symptoms, pelvic discomfort and pain.

RATIONALE: Large cohort studies have revealed that frequent ejaculation is associated with higher risk of prostatitis, especially in young men. Also, clear evidences from sports medical research has shown that intense muscular contraction will lead to locally increased production of free radicals and lactic acid. Therefore, the pelvic muscles during ejaculation would induce substantial increase of these byproducts, which if not cleared effectively, could trigger series of local cellular/tissue damages resulting in inflammation, muscular fatigue and dysfunction. If our hypothesis were validated, it could be suggested that at least in some patients, the treatment of CP/CPPS could be tuned as dealing with post-sports recovery, such as hot bath to promote local blood circulation and free radical scavenger drugs such as vitamin C and E to neutralize free radicals.